Early and medium-term results of total joint arthroplasty of first carpo-metacarpal joint

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Introduction. Reviews dedicated to surgical treatment of the first carpo-metacarpal joint repeatedly state that the evaluation of arthroplasty results is difficult. This is due to the small clinical study groups and the lack of description of all types of outcomes.

The aim of the study is to analyze obtained early and midterm results of ceramic CMC-arthroplasty. The endoprosthesis are represented with unbound proximal and distal components made of ceramic material. The interaction of the head and cup is represented with no intersecting forces that impede on the multi-axial movement. The surgical technique of CMC-1 joint arthroplasty prescribes the installation of components by the press-fit fixation. There is a brief emphasis on the features of the joint and contributing factors for the development of risarthrosis. Early results are described. Cases of unsatisfactory outcomes are described separately.

Materials and methods. The study group included patients from 33 to 72 years. The total number of observers was 28 people. We performed revision endoprosthetics in 2 cases (7%), which were associated with aseptic instability of the proximal component according to the osteoporosis. It obvious that endoprosthetics is the only method of orthopedic care that allows maintain mobility and achieve stability of the destroyed CMC joint. Evaluation of the results was carried out by clinical and instrumental methods.

Results. It cannot be denied that the CMC arthroplasty is the only method of orthopedic care that allows to preserve mobility and achieve stability of the broken joint.

Conclusion. Arthroplasty of the carpo-metacarpal joint with ceramic implants is a promising method of orthopedic care, that allows to restore the function of the hand.

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About the authors

Ekaterina N. Simonova

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: nepalopeno@mail.ru

Russian Federation, Novosibirsk

graduate student

Timofei I. Aleksandrov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics; Novosibirsk State Medical University

Email: tymus@inbox.ru

Russian Federation, Novosibirsk

MD, Cand. Sci. (Med.), senior researcher

Valeriy M. Prokhorenko

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics; Novosibirsk State Medical University

Email: VProhorenko@niito.ru

Russian Federation, Novosibirsk

MD, PhD, Dr. Sci. (Med.), Professor, chief researcher


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Supplementary files

Supplementary Files Action
Fig. 1. Ceramic components of endoprosthesis of 1st carpo-metacarpal joint: a — distal component, b — proximal component

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Fig. 2. Appearance and X-ray of the hand: a, b — pre-operative X-ray; c, d — postoperative X-ray; e, f, g — functional tests after operative treatment

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Fig. 3. Results of dynamometric measurements in different clinical study timepoints

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